不同髓内钉内固定术在胫骨远端关节外骨折治疗中的效果比较

Comparison of the Effects of Different Intramedullary Nail Fixation Techniques in the Treatment of Distal Tibial Extra-Articular Fractures

目的 比较不同髓内钉内固定术治疗胫骨远端关节外骨折的效果。方法 前瞻性选择2021年1月至2022年6月濮阳市人民医院骨科收治的80例胫骨远端关节外骨折患者,以随机数字表法分为A组与B组,各40例。A组接受逆行髓内钉内固定术,B组接受交锁髓内钉内固定术。比较两组术后3个月的临床疗效。比较两组围手术期指标、踝关节功能、术后并发症发生情况。结果 两组术后3个月的临床效果差异无统计学意义(P>0.05)。A组手术时间短于B组(P<0.05);两组术中出血量、骨折愈合时间差异无统计学意义(P>0.05)。术后3个月,两组踝后足功能评分(AOFAS)评分均升高,但B组低于A组(P<0.05)。B组术后并发症发生率高于A组(P<0.05)。结论 逆行髓内钉与交锁髓内钉固定术治疗胫骨远端关节外骨折均可获得理想疗效,且应用逆行髓内钉可有效缩短手术时间,并能够加速踝关节功能恢复,降低并发症发生率。

Objective To compare the clinical effects of different intramedullary nail fixation techniques for the treatment of distal tibial extra-articular fractures.Methods Eighty patients with extraarticular fractures of the distal tibia admitted to the Department of Orthopaedics,Puyang People’s Hospital from January 2021 to June 2022 were prospectively selected and divided into group A and group B by random number table method,40 cases in each group.Group A patients received retrograde intramedullary nail fixation,while group B patients received interlocking intramedullary nail fixation.The clinical effects of the two groups were compared three months after operation.The perioperative indexes,ankle function and postoperative complications were compared between the two groups.Results There was no statistical differences in clinical effect between the two groups three months after operation(P>0.05).The operation time in group A was shorter than that in group B(P<0.05).There was no statistical differences in intraoperative blood loss and fracture healing time between the two groups(P>0.05).Three months after operation,both groups showed an increase in ankle foot function score(AOFAS),but group B was lower than group A(P<0.05).The incidence of postoperative complications in group B was higher than that in group A(P<0.05).Conclusion Both retrograde intramedullary nail and interlocking intramedullary nail fixation can achieve ideal curative effect in the treatment of extraarticular fracture of distal tibia,and the application of retrograde intramedullary nail can effectively shorten the operation time,accelerate the recovery of ankle joint function and reduce the incidence of complications.